中国冶金工业医学杂志

高容量血液滤过在多器官功能障碍综合征患者中临床应用评价

作者：张殿红刘兆润唐利平杨辉陈汉敏

分类号：R 59

出版年,卷(期):页码：2010,27(5):497-499

摘要：

目的：观察高容量血液滤过(HVHF)对多器官功能障碍综合征(MODS）患者炎症介质的清除作用，探讨HVHF对MODS患者的治疗效果。方法：19例MODS患者随机分为两组，HVHF治疗组10例，连续性静脉-静脉血液滤过(CVVH）治疗组9例；用酶联免疫吸附法（ELISA）测定HVHF和CVVH治疗前和治疗后患者血清中肿瘤坏死因子\|α(TNFα)、白细胞介素\|6(IL\|6)、白细胞介素\|8(IL\|8)水平，并观察两组患者的死亡率和血浆尿素氮(BUN)、肌酐(Scr)值的变化。结果：HVHF和CVVH治疗后，患者血浆中BUN、Scr均降低(P＜005)，两组患者治疗后与治疗前相比血清TNFα、IL\|6、IL\|8水平均有下降(P＜005);与CVVH治疗组相比,HVHF治疗组患者血清中TNFα、IL\|6、IL\|8 下降更为明显(P＜005)。结论：HVHF治疗能明显增加MODS患者血清中TNFα、IL\|6、IL\|8的清除能力，改善MODS患者的预后。

To observe the effects of high\|volume hemofiltration (HVHF) on the cytokines in the patients with multiple organ dysfunction syndrome and to investigate the therapitic action of HVHF for the patients with MODSMethods:19 patients with multiple organ dysfunction syndrome were randomly divided into HVHF group(n=10)and CVVH group(n=9),the levels of serum tumor necrosis factor\|α(TNF\|α),interleckin\|6(IL\|6)and interleckin\|8(IL\|8)were measured by enzyme\|linker immunoadsorbent assay(ELISA)before and after the therapy,and to observe the death rates and the levels of BUN and Scr.Results:Compared with that before the therapy ,the average concentrations of plasma creatinine and urea were decreased significantly after HVHF or CVVH(P＜005)The level of TNF α ,IL\|6,IL\|8 in two groups all decreased after HVHF or CVVH (P＜005);Compared with CVVH group,the level of TNF α ,IL\|6,IL\|8 after the HVHF curing were lower(P＜005).Conclusions:HVHF could decrease the levels of inflammatory mediator in the patients with MODS,and improve the survival rate of MODS patients

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参考文献：

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